Document Detail


Prenasal Thickness-Nasal Bone length ratio: a strong and simple second and third trimester marker for trisomy 21.
MedLine Citation:
PMID:  21584886     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective To study the ratio between prenasal thickness (PT) and nasal bone length (NBL) in normal and trisomy 21 fetuses in the second and third trimester of pregnancy. Methods The PT and NBL were measured retrospectively in 106 normal fetuses (in three-dimensional (3D) volumes) and in 30 trisomy 21 fetuses (10 on two-dimensional images (2D) and 20 in 3D volumes). Results In normal fetuses the mean PT and NBL increased between 15 and 33 weeks from 2.3 to 6.1 mm (r = 0.85, P<0.001) and from 3.3 to 9.6 mm )r=0.87, P<0.001), respectively. The PT/NBL ratio is stable throughout gestation with a mean of 0.61 )95%Ci: 0.59-0.63, r= -0.04, P=0.7). The 5th and 95th percentiles are 0.5 and 0.8 respectively. In trisomy 21 fetuses the mean PT and NBL increased between 14 and 34 weeks from 3.0 to 9.2 mm (r= 0.86, P<0.001) and from 1.9 to 7.8 mm )r=0.85, P<0.001), respectively. The PT/NBL ratio was significantly higher )P<0.001) but also stable throughout gestation with a mean of 1.50 )95%Ci: 1.20-1.80, r= -0.35, P=0.07). Seventy-seven % )23/30) of the trisomy 21 fetuses had a PT above the 95th percentile and 67 % )20/30) had a NBL below the 5th percentile. All the trisomy 21 fetuses had a PT/NBL ratio above the 95th percentile. When the 95th percentile of the PT/NBL ratio is used as cut-off value the detection and false positive rates for trisomy 21 are 100 )95%Ci: 89-100)% and 5 )95%Ci: 2-11)%, respectively. The positive likelihood ratio is 21.2. Conclusions The PT/NBL ratio is stable in the second and third trimester of pregnancy in both normal and trisomy 21 fetuses. All trisomy 21 fetuses in this series had a PT/NBL ratio above the 95th centile. The ratio is therefore a strong marker for trisomy 21. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
E A P de Jong-Pleij; F I Vos; L S M Ribbert; L R Pistorius; E Tromp; C M Bilardo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-16
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, St. Antonius Hospital Nieuwegein, The Netherlands. e.de.jongpleij@xs4all.nl.
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